title: Treatment of hypomagnesemia.
abstract: Serum magnesium concentration is determined by the interplay of intestinal absorption and renal excretion. Hypomagnesemia can occur as a result of insufficient magnesium intake, increased gastrointestinal or renal loss, or redistribution from extracellular to intracellular compartments. A number of drugs are known to cause hypomagnesemia, including proton pump inhibitors (PPIs). We report the case of a patient with symptomatic hypomagnesemia due to short bowel syndrome and PPI therapy. Investigations revealed low 24-hour urinary magnesium excretion and secondary hypocalcemia. PPI treatment was withdrawn and the patient was managed with intravenous and oral magnesium and calcium replacement. This teaching case provides an evidence-based discussion of the treatment of hypomagnesemia.
authors.affiliation: Department of Endocrinology, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Ayuk
authors.affiliation: Department of Endocrinology, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom. Electronic address: neil.gittoes@uhb.nhs.uk.
authors.forename: Neil J L
authors.initials: NJ
authors.lastname: Gittoes
mesh_terms: D058070:Asymptomatic Diseases; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology; D008274:Magnesium / Q000097:blood; D017616:Magnesium Compounds / Q000008:administration & dosage*; D008275:Magnesium Deficiency / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012778:Short Bowel Syndrome / Q000150:complications
chemical_list: D017616:Magnesium Compounds; D054328:Proton Pump Inhibitors; D008274:Magnesium
keywords: Hypomagnesemia; intravenous magnesium sulfate; oral magnesium salts; proton pump inhibitor; treatment